ABSTRACT
Introduction .................................................................................................................................... 318 Enteral Nutrition ............................................................................................................................ 318
Standard Formula ...................................................................................................................... 318 Composition ......................................................................................................................... 318 Volume and Osmolality ........................................................................................................ 319 Recommended Daily Intakes ................................................................................................ 319
Fiber .......................................................................................................................................... 319 Prebiotics .............................................................................................................................. 319 Soluble Fibers ....................................................................................................................... 320
Diabetic ..................................................................................................................................... 320 Renal ......................................................................................................................................... 321 Hepatic ...................................................................................................................................... 322 Pulmonary ................................................................................................................................. 323 Immune Enhancing ................................................................................................................... 324
Arginine ................................................................................................................................ 325 Arginine and Nitric Oxide .................................................................................................... 325 Glutamine ............................................................................................................................. 325 Summit on Immune-Enhancing Formulas ........................................................................... 326 Guidelines ............................................................................................................................. 326
Semielemental and Elemental ................................................................................................... 326 Enteral Access ................................................................................................................................ 327
Nasoenteric Tube Access ........................................................................................................... 327 Newer Technologies ............................................................................................................. 329
Percutaneous Endoscopic Enteral Access ................................................................................. 330 Percutaneous Endoscopic Gastrostomy................................................................................ 330 Percutaneous Endoscopic Gastrostomy Procedure Kits ....................................................... 332 Percutaneous Endoscopic Gastrostomy Malfunction ........................................................... 332 Other Percutaneous Endoscopic Gastrostomy Complications ............................................. 333 Percutaneous Endoscopic Gastrostomy Dislodgement ........................................................ 333 Replacement Percutaneous Endoscopic Gastrostomy Tubes ............................................... 333 Percutaneous Endoscopic Gastrojejunostomy...................................................................... 334 Direct Percutaneous Jejunostomy ........................................................................................ 335
Surgical Enteral Access ............................................................................................................. 335 Surgical Gastrostomy ........................................................................................................... 335 Surgical Jejunostomy ........................................................................................................... 335 Laparoscopic Surgical Approaches to Enteral Access Device Placement ............................ 335
Enteral nutrition (EN) has been shown to be capable of changing disease outcomes in at-risk patients. Recent advances in particular areas of EN, such as immune-enhancing enteral formulas, hold much promise as a mainstay of the treatment of critically ill patients. However, without enteral access, EN cannot be delivered. Therefore, the intricate knowledge of both EN and enteral access are vital to providing effective nutritional therapy to patients.
